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potential for evil in others. These can only be discovered by a
frequent inspection of the throats of all scholars by a qualified
medical man, and in the light of our present knowledge of
diphtheria infection it will be necessary to treat every case of sore
throat as potentially infectious, when diphtheria is epidemic.
Nor do I consider that even a bacteriological examination—
when this gives negative evidence—will warrant one in regarding
the case as harmless to others. I have, during the year in question,
examined the exudation of a severe sore throat (acute follicular
tonsillitis) and found no evidence whatever of the germ of diphtheria
(the Klebs-Loeffler bacillus), whereas I have obtained from the same
throat within 48 hours afterwards the diphtheria bacillus in large
quantities.
It is satisfactory to note that coincident with the increase in
the number of cases of diphtheria, the fatality per cent, of cases
shows a marked and growing tendency to diminish.
Puerperal Fever.—This fatal malady is most frequently caused
by neglect of cleanly and proper precautions among women who
have very recently been confined. In many cases it is found to
have arisen from the negligence and ignorance of women who call
themselves midwives, but who are untrained, and whose knowledge
of antiseptic precautions is frequently nil. Too much care cannot
be exercised in the selection of a nurse, where ignorance and lack
of training may lead to such dire consequences.
The deaths (2) from puerperal fever in Stoke Newington
furnished a rate of 3.4 per 1,000 registered births, a figure which
is well below that of England and Wales, which amounts to over
5; but as this is essentially a disease which by the exercise of
proper care by those in attendance upon the patient, and by the
adoption of proper sanitary precautions in our homes, is so easily
prevented, any mortality, however small, is all the more
regrettable.